This three-year study which commenced October l, 1978 is designed to determine which factors discriminate between the adoption and nonadoption of primary preventive health measures in United States public schools. School-based self-applied fluoride programs have been selected as the prototype measure for study because of their ongoing rapid adoption within schools where an estimated 12 million children are currently participating in either fluoride rinse or tablet programs. The study design is based on specific hypotheses derived from classical diffusion of innovation theory and research concerning the diffusion of medical and educational innovations. Through a series of mailed questionnaires to superintendents, principals, school health personnel, as well as site visits for in-depth analysis of the adoption process, data will be collected about who makes and influences decisions about health programs, aspects of the health measure itself that make it attractive to adopt, barriers and problems in implementing self-applied fluoride procedures including the extent of inappropriate or incorrect implementation; and an assessment of the extent to which schools are feasible sites for providing other health and medical services. Discriminant function and regression analyses will be used to determine whether and to what extent the hypotheses proposed explain schools' decision whether or not to adopt self-applied fluoride rinse programs or other preventive measures.